Achilles Tendinopathy

What is it ?

The Achilles tendon is the largest tendon in your body that connects the calf muscles to the heel bone and is used when you walk, run, climb stairs, jump, and stand on your tiptoes. Achilles tendinopathy is a common overuse injury whereby the Achilles tendon undergoes degenerative changes, leading to weakened tendon fibers and microtears, which results in pain, swelling, stiffness and weakness of the Achilles tendon.

Causes

• Overuse of tendon

• Sudden increase in the amount or intensity of exercise activity

• Abnormal foot posture/biomechanics of feet (flat feet or a high arch)

• Ill-fitting shoes: Footwear with insufficient heel height, rigid soles, inadequate shock absorption or uneven wear.

• Tight calf muscles

• New terrain / running on hard or hilly surfaces.

Signs and Symptoms

• Pain and stiffness along the Achilles tendon in the morning

• Pain along the tendon or back of the heel that worsens with activity

• Severe pain the day after exercising

• Thickening of the tendon

• Swelling that may be present all the time and can get worse throughout the day or with activity

• Bone spur formation (insertional tendinitis)

Treatment

• Activity modification and load management

• Footwear modification and orthotic therapy to correct biomechanical abnormalities

• Exercise therapy: including strengthening and stretching exercises of calf muscles

• Over the counter anti-inflammatory medications to provide immediate relief

• Physical therapy including low-level laser therapy, myofascial release or dry needling

• Strapping